Melnyk's randomized controlled pilot study of Hispanic adolescent health

¶ … Improving the Mental Health, Healthy Lifestyle Choices, and Physical Health of Hispanic Adolescents: A Randomized Controlled Pilot Study" by Melnyk and colleagues is a reaction to a seldom studied area of adolescent health research. Preventing the most common mental health disorders and obesity of some of the most dominant health concerns in America today, and Melnyk and associates are aware that the bulk of that prevention needs to come during this vulnerable time of adolescence. Giving teenagers the tools and the coping mechanisms and behaviors that they need in order to develop into healthy adults is absolutely essential for society and for the professional healthcare arena. This means that it is thus crucial to engage in concerted, focused efforts to empower such young people with practical tools they can use to become healthy, active adults. Another factor that Melnyk and colleagues have focused on is the fact that while obesity in young people might be at 17% in America, with Hispanic young people this number is double, at 34% (2009). "Despite the rapidly increasing incidence and adverse health outcomes associated with overweight and mental health problems, very few intervention studies have been conducted with adolescents to improve both their healthy lifestyles and mental health outcomes. Even fewer studies have been conducted with Hispanic youth" (Melnyk et al., 2009, p 575). This is truly serious as being overweight as a teenager sets one up for an adulthood with a vulnerability to even more adverse outcomes like heart disease and diabetes. Not only do such things set one up for a shorter life with a lower quality of life, such serious conditions put an intense strain on the healthcare profession as a whole in a very real fiscal manner. Thus, by selecting this area of focus alone, Melnyk and colleagues are demonstrating that they have an acute understanding of the very pertinent needs of society and of the vulnerable youths within that society.

Theoretical Framework

Rather than originating from a nursing framework, the framework originated from a social sciences background, despite the fact that a portion of the authors of the study are nurses. Cognitive behavioral theory was one of the guiding overall principles which influenced the development of COPE process and which had a major influence on the study as a whole. This particular theory believes that one's thoughts and emotions have a tremendous impact on how one views the world and one's place in it (Melnyk et al., 2009). In this sense, the report does do an adequate job in discussing major features of the framework. The article has a lucid theoretical framework. This theoretical framework is easy enough to navigate and it was easy to see what theories guided the research in the first place and the impetus for why the COPE program was tested and developed. For example, the authors spend a cursory amount of time explaining how negative emotions, in conjunction with poor coping skills and mechanisms can lead to truly adverse outcomes for youths who later grow into adults with poor coping mechanisms.

The framework of the research that was created does connect to the research paradigm presented and is relevant to some truly formidable worldwide issues. For instance, the study had a very clear purpose and hypothesis and the research problems appear to flow very naturally from the framework. "e purpose of this recently completed randomized controlled pilot study was to determine the effects of the COPE/Healthy Lifestyles TEEN (thinking, emotions, exercise, and nutrition) program on the mental and physical health outcomes of 19 Hispanic adolescents enrolled in an inner city high school. The intervention programs (COPE vs. Comparison) were delivered in two separate classes of teens who were taking a required health class. Programs were twelve sessions over a nine-week school quarter for both groups" (Melnyk et al., 2009). This demonstrates a lucid amount of organization within the theoretical design and supports the hypothesis, which was that the COPE program was going to have a tangibly positive benefit on the mental and physical outcomes for adolescents with a clear and concrete reduction in the amount of adverse affects and symptoms of poor mental and physical health. Furthermore, within the theoretical framework, definitions are clear and sufficiently detailed, providing the reader with enough background so that all decisions and details made and provided within the study are fathomable. One can see how within the COPE program, teens are given a range of tools to help support their needs for developing proper tools and coping mechanisms for all sorts of stress and for preventing stress. Based on all these aspects, one can see that the framework was able to provide a strong guide for the study methods as a whole.

Outcomes

The Outcomes of the research were very clear and not at all ambiguous and they demonstrated the necessity of such a thorough and easy to find research design. "Adolescents in the COPE program increased their healthy lifestyle choices and reported a decrease in depressive and anxiety symptoms from baseline to postintervention follow-up. A subset of 7 overweight adolescents in the COPE program had a decrease in triglycerides and an increase in high-density lipoproteins" (Melnyk et al., 2009). This demonstrates an aspect of the hard evidence that the study was able to amply provide as a means of supporting the hypothesis presented at the start of the study. The science presented lucid results that mirrored almost precisely what the researchers had predicted would happen.

Another overwhelming benefit of the outcomes was that it demonstrated some of the mental and emotional changes that would have to take place in order for these adolescents to grow into happier, healthier adults. Attitudes inform behavior more than anything; as these researchers have demonstrated healthy attitudes need to be established at the vulnerable time of adolescence in order to foster the development of healthy adults. "In addition, these overweight adolescents reported increases in healthy lifestyle beliefs and nutrition knowledge along with a decrease in depressive symptoms" (Melnyk et al., 2009). This demonstrates that the researchers were indeed aware that part of the changes with these adolescents would occur through empowerment.

Ethical Issues

Ethical issues need to be examined and the ethical rights of all participants need to be protected in every study, though the issue becomes more exacerbated when working with youths (LoBiondo-Wood et al., 2010). The researchers in this study took extra care to ensure that all of their young participants knew that their participation was truly up to them and that it was optional. The adolescents were explained all aspects of the study and what would be asked of them so that they were able to go into the study with both eyes open. Furthermore, their privacy and confidentiality was clearly explained and protected, along with all other important aspects.

Limitations

The fundamental limitation of this study was that it only occurred for a short period of time and that it involved such a small sample. More than anything, these researchers were able to forge almost flawless research and promising results with what was essentially a micro-study, but that was it. Further research in this vein needs to be conducted to re-test the hypothesis and the findings of the study. More likely than not, however, the findings will be similar and promising.